Eyedeal Vision Center

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

27OA00604800 Issued in NJ

Legal business name

EYEDEAL VISION CENTER

Practice address

222 Bergen Blvd
Unit 1
Fairview, NJ 07022-1300

Phone

(201) 945-2525

Fax

(201) 945-2528

NPI assigned

Mar 17, 2015

Last updated

Mar 17, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mustapha KaddourNPI 1164814539

Title

Owner

Phone

(201) 945-2525

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mustapha Kaddour

  • Optometrist
  • Fairview, NJ
  • NPI 1164814539
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1386037141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 BERGEN BLVD",
            "address_2": "UNIT 1",
            "city": "FAIRVIEW",
            "state": "NJ",
            "postal_code": "070221300",
            "telephone_number": "201-945-2525",
            "fax_number": "201-945-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BERGEN BLVD",
            "address_2": "UNIT 1",
            "city": "FAIRVIEW",
            "state": "NJ",
            "postal_code": "070221300",
            "telephone_number": "201-945-2525",
            "fax_number": "201-945-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDEAL VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "KADDOUR",
        "authorized_official_first_name": "MUSTAPHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-945-2525",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "27OA00604800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther O Chucaralao, LAC
• Diana Cubillos
• Robert Edward Douglas II, LMFT. LPC
• Dr. Brian E. Kiczek (Aarya Chiropractic)
• Sarah Elhalawani
• Fair Ridge Pharmacy Inc (Fair Ridge Pharmacy)
• Fairview Board of Education
• Fairview Imaging Center Inc
• Fairview Pharmacy LLC (Fairview Pharmacy)
• Ryan Thomas Finucane, PT

• Health Maintenance Organization in Fairview, NJ
• Providers in Fairview, NJ by specialty
• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.